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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 -www.everettwa.gov <br /> Lt> <br /> PROJECT ADDRESS <br /> Owner Mail Address City State/Zip Phone <br /> L n Vcp Q -3 (Q (U�L [ A I (AJA <br /> Tenant Mail Address City State/Zip Phone <br /> (� _o2S�i`u/1(�1�..s h���� A e. S Ve-r�k a JA Q-ejc) jat i y o <br /> Electrical Contractor Mail Address City State/Zip Phone <br /> (XS EAJG 1%3-FE <br /> State License Number(required) City of Everett Business License Number(required) <br /> Proposed Use of Building kontract Price of Work <br /> JASE"n rJolkneVV' - <br /> Square Footage(If residential new construction, remodel or addition) Contact Person/Contact Number/Email <br /> Number of devices(If low voltage) <br /> Description of Work to Be Done: –1,100ou �U�GI t ( — G� V VA <br /> �- IDSA OZ06V \r 47or <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 0 <br /> I hereby certify that I have read and examined this application and know the same to be true and <br /> correct. All provisions of laws and ordinances governing this type of work will be completed <br /> whether specified herein or not. The granting of a permit does not presume to give authority to PERMIT# <br /> violate or cancel the provisions of any other state or local law regulating construction or the <br /> performance of construction. That I am authorized by the owner of this property to perform the E It I I <br /> work for which application is made and I comply with the State Contractors Law 18.27 RCW and 6 <br /> 296.20 AC. <br /> ture Dat <br /> REVISED 08/062014 <br />